NPIMap

Organization Active NPI

University Physicians of Brooklyn, Inc.

Doing business as Downstate University Urology

  • Urology Physician
  • Brooklyn, NY
National Provider Identifier
1447207998
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
UNIVERSITY PHYSICIANS OF BROOKLYN, INC.
Doing business as
Downstate University Urology
Practice address
450 Clarkson Ave
Suite I
Brooklyn, NY 11203-2056
Phone
(718) 270-2554
Fax
(718) 270-3848
NPI assigned
May 30, 2006
Last updated
Jul 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Melissa Rivera
Title
Director
Phone
(718) 270-7370

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X Primary

Addresses

Primary practice location

450 Clarkson Ave
Suite I
Brooklyn, NY 11203-2056

Mailing address

450 Clarkson Ave
Box 1262
Brooklyn, NY 11203-2056
Phone (718) 270-7379

Other identifiers 1

IdentifierTypeStateIssuer
02310667MedicaidNY

Other names 1

  • Downstate University Urology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040401000120 NY Part B Supplier - Clinic/Group Practice 0749192284 Receives reassigned benefits from 285 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brooklyn, NY; Floral Park, NY; Monsey, NY; New York, NY; Rockaway Park, NY; Staten Island, NY; Belle Harbor, NY

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Downstate Health Physicians24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1447207998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "BOX 1262",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-7379",
            "fax_number": "718-270-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "SUITE I",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-2554",
            "fax_number": "718-270-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PHYSICIANS OF BROOKLYN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-270-7370"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02310667",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Downstate University Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.